Baccalaureate Nursing Students' Self-Care Beliefs and Practices Prior to Graduation

Purpose: Baccalaureate nursing students experience a significant amount of stress and anxiety throughout their nursing education. Nurse educators play a vital role to mentor, educate, and promote self-care practices for nursing students to help lower anxiety and stress. Nursing students recognize the value of self-care practices but do not employ these strategies. Therefore, nurse educators need to look into barriers of self-care practices for senior-level pre-licensure baccalaureate nursing students prior to graduation. Employment of self-care practices prior to graduation can lay the foundation for students to manage stress and anxiety as they enter a highly stressful workforce. Therefore, the purpose of this mixed-methods study was two-fold. The study aimed to examine if the inclusion of SMS messages as an interventional strategy lowered state anxiety and improved stress management practices and interpersonal relations. Secondly, the study examined the perceptions, beliefs, and self-care practices among senior-level baccalaureate nursing students prior to graduation.

Methods: A two-group experimental, longitudinal study (n=31) was conducted at six public and private traditional baccalaureate nursing programs in Pennsylvania during the spring academic semester. Pender’s Health Promotion Model was the theoretical framework used to guide this study. Nursing students randomized to the intervention group received ten weekly SMS messages based on the stress management and interpersonal relations strategies in the ANA’s Self-Care and You: Caring for the Caregiver. The State-Trait Anxiety Inventory and the Health-Promoting Lifestyle Profile subscales for stress management and interpersonal relations were completed three times over the course of the semester. Six open-ended questions were completed the last two weeks of the semester and offered valuable insight into the self-care perceptions and practices of graduating senior nursing students.

Results: A mixed-between within subjects analysis of variances was performed and revealed that there was no significance between the randomized groups for the state anxiety (p = 0.99), stress management subscale (p = 0.07), or the interpersonal relations subscale (p = 0.12). A content analysis was performed on the six-open ended questions. The questions focused on senior-level pre-licensure baccalaureate nursing students’ definitions of self-care and its impact on their academic performance, obstacles in performing self-care, recommendations for nursing faculty to support self-care, and their plan to engage in self-care activities after graduation. Findings indicated that time, workload, and personal factors were barriers for performing self-care activities for senior-level pre-licensure baccalaureate nursing students. Nursing students recognized that their academic performance was more successful when they engaged in self-care. Commonly reported self-care practices that would be utilized after graduation included exercise, yoga, and sleep. Nurse educators were identified as perceived barriers to engage in self-care practices.

Conclusion: Nursing faculty play a vital role to mentor, educate, and role model effective self-care practices for nursing students. Results indicated that time, workload, and relational factors played a role in their inability to perform self-care. Recommendations and implications of this study can guide nursing faculty and students to explore new avenues to integrate self-care practices into their coursework. Future studies should explore this study’s findings and the time management of nursing students.